ActinicKeratosesNet Spotlight Article
How to Check for Actinic Keratoses (AKs) During Skin Self-Exam
For anyone who has spent years in the
sun or frequently used tanning beds, regular skin exams are vital.
Repeat exposure to ultraviolet (UV) rays, whether from the sun or
tanning beds, can severely damage the skin. Over time, this damage
can build up and cause actinic keratoses (AKs).
AKs appear on the skin as dry, scaly, rough-textured spots or
patches. While most patients want AKs removed for cosmetic reasons,
there is another reason to get them treated. AKs are considered the
earliest stage in the development of skin cancer. Some AKs progress
to squamous cell carcinoma (SCC), a type of skin cancer that can
spread. Having AKs also increases the risk of developing other types
of skin cancer.
The key to finding AKs and all types of skin cancer is regular skin
exams. These exams help find AKs and all types of skin cancer in the
earliest and most treatable form. Dermatologists recommend two types
of skin exams — regular exams from a dermatologist and skin
self-exams between appointments.
Dermatologists’ Tips for Finding AKs
Here are some tips to help find AKs during a skin self-exam:
Recruit a partner. You may
want to ask a partner such as a spouse to help with the exam. A
recent study found that people who involve a partner are
significantly more likely to perform regular skin self-exams. A
partner also makes it easier to examine areas such as the back
Use the fingertips to find early
AKs. AKs often can be felt before they are seen. To find AKs
in their earliest form, run the fingertips over all skin
weathered by years of sun exposure and showing signs of UV
damage. Skin damaged by overexposure to UV rays tends to be dry,
discolored, and wrinkled.
When feeling for signs of early AKs, carefully examine skin that
tends to receive years of sun exposure — face, ears, lips,
scalp, neck, forearms, and backs of the hands.
While running the fingertips over weathered skin, ask the
Does any skin feel rougher
than the surrounding skin? Pay close attention to the
texture of the skin. Emerging AKs feel rougher than the
surrounding skin, often like sandpaper, and may have a scaly
or warty texture.
How does the skin on the
ears feel? The ears often receive years of unprotected
sun exposure. Are there any rough spots on the ears?
Does a lip feel scaly and
dry? Does it tend to crack? These may be signs of an AK
on the lip. Called “actinic cheilitis” when it develops on
the lip, this lesion may cover a large area of the lip.
Look for visible signs of AKs on
the skin. As AKs grow, they can be seen on the skin. Visible
AKs tend to be skin colored or reddish. To spot visible AKs
while examining the skin, ask:
Are there spots or patches
on the skin that resemble a red bump; scattered, thick red
scaly patches; or crusted lesions varying in color from red
to brown? AKs may appear in any of these forms.
Does a growth on the skin
resemble a horn? Sometimes an AK grows rapidly upward.
When it does this, dermatologists call the growth a
“cutaneous horn” because it resembles an animal’s horn. The
size of a cutaneous horn may range from that of a pinhead to
a pencil eraser; the horn may be straight or curved.
Sometimes skin cancer hides beneath a cutaneous horn.
If a spot or patch resembles any of the
above descriptions, be sure to contact a dermatologist. A
dermatologist’s medical training makes this doctor uniquely
qualified to diagnose the lesion and to decide if a lesion should be
biopsied or treated.
Robinson JK et al. “Examination of mediating variables in a partner
assistance intervention designed to increase performance of skin
self-examination.” Journal of the American Academy of
Dermatology. 2007 March;56(3):391-397.
All content solely developed by the American Academy of